| 胡勇,徐荣明,董伟鑫,袁振山,马维虎,孙肖阳.寰枢椎后路切开复位内固定术治疗陈旧性齿突骨折伴C1,2不稳症[J].脊柱外科杂志,2014,12(3):138-142. |
寰枢椎后路切开复位内固定术治疗陈旧性齿突骨折伴C1,2不稳症  点此下载全文 (Fulltext) |
| 胡勇 徐荣明 董伟鑫 袁振山 马维虎 孙肖阳 |
| 宁波市第六医院脊柱外科, 浙江, 315040;宁波市第六医院脊柱外科, 浙江, 315040;宁波市第六医院脊柱外科, 浙江, 315040;宁波市第六医院脊柱外科, 浙江, 315040;宁波市第六医院脊柱外科, 浙江, 315040;宁波市第六医院脊柱外科, 浙江, 315040 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2014.03.003 |
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| 摘要： |
| 目的 分析寰枢椎后路切开复位内固定术治疗陈旧性齿突骨折伴C1,2不稳的临床疗效。方法 2008年5月～2012年5月，对32例陈旧性齿突骨折伴C1,2不稳的患者进行寰枢椎后路切开复位内固定术。根据Anderson-D’Alonzo分型，其中Ⅱ型23例，Ⅲ型9例。从受伤开始到手术治疗时间为6个月～3年，平均19个月。结果 所有患者均行寰枢椎后路切开复位内固定术，术中未伤及椎动脉和脊髓。平均手术时间100 min；术中平均出血量290 mL。患者术后平均随访18个月。在术后8个月随访时，患者骨折端均获得骨性融合，随访中未出现螺钉松动、断钉、移位等情况。寰齿前间距由术前7.5 mm缩小至术后2.8 mm （P<0.05）。日本骨科学会（Japanese Orthopaedic Association，JOA）评分由术前12.5±2.2改善至术后15.4±1.4（P<0.05）。在末次随访中，3例患者Frankel分级从D级改善为E级。结论 寰枢椎后路切开复位内固定术治疗陈旧性齿突骨折合并C1,2不稳是一种安全有效的方法。 |
| 关键词：寰枢关节 齿突尖 脊柱骨折 脱位 内固定器 |
| Atlantoaxial posterior open reduction and internal fixation for old odontoid fracture with C1,2 instability Fulltext |
| HU Yong XU Rong-ming DONG Wei-xin YUAN Zhen-shan MA Wei-hu SUN Xiao-yang |
| Department of Spinal Surgery, Ningbo No.6 Hospital, NingBo 315040, Zhejiang, China;Department of Spinal Surgery, Ningbo No.6 Hospital, NingBo 315040, Zhejiang, China;Department of Spinal Surgery, Ningbo No.6 Hospital, NingBo 315040, Zhejiang, China;Department of Spinal Surgery, Ningbo No.6 Hospital, NingBo 315040, Zhejiang, China;Department of Spinal Surgery, Ningbo No.6 Hospital, NingBo 315040, Zhejiang, China;Department of Spinal Surgery, Ningbo No.6 Hospital, NingBo 315040, Zhejiang, China |
| Fund Project: |
| Abstract: |
| Objective To analyze the clinical results of atlantoaxial posterior open reduction and internal fixation for old odontoid fracture with C1,2 instability.Methods From May 2008 to May 2012, 32 patients with old odontoid fractures combined with C1,2 instability were treated with atlantoaxial posterior open reduction and internal fixation. By the Anderson-D'Alonzo classification,there were 23 cases of typeⅡand 9 cases of type Ⅲ. The duration from injury to operation averaged 19 months, ranging from 6 months to 3 years.Results All patients were performed atlantoaxial posterior open reduction and internal fixation, no intraoperative vertebral artery injury and spinal cord injury occurred. The average operative time was 100 minand the average blood loss was 290 mL. Patients were followed up for an average of 32 months, all the patients achieved bone fusion at 6 months postoperation,and no loosening,breakage or displacement of the screws was found in the follow-up.The atlanto-dens interval(ADI)was decreased from 7.5 mm preoperative to 2.8 mm postopertive(P<0.05). The Japanese Orthopaedic Association(JOA) score was improved from 12.5±2.2 preoperative to 15.4±1.4 postoperative (P<0.05).At the final follow-up, according to the Frankel classification,3 patients had improved from grade D to grade E.Conclusion Atlantoaxial posterior open reduction and internal fixation was an safe and effective method for old odontoid fracture with C1,2 instability. |
| Keywords:Atlanto-Axial Joint Odontoid Process Spinal fractures Dislocations Internal fixators |
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